Men who are obese or gain more than 20 pounds (lbs.) have a greatly increased risk of developing gout, but men who lose 10 lbs. or more can significantly lower their risk, a new study shows. Researchers recruited a group of 47,150 men, ages 40–75, who had no history of gout. During a 12-year follow-up period, 730 of them developed gout. The risk was 2 times greater for overweight men (a body mass index [BMI] of 25 or higher) and almost 3 times greater for very obese men (BMI, 35 or higher), compared to normal weight men (BMI, 21–23).
Men who had gained 30 lbs. or more after age 21 also had twice the risk of gout compared to men who had maintained the same weight since age 21 (gaining or losing 4 lbs. or less). In contrast, men who had lost 10 lbs. or more during the 12-year study period had a 39% lower risk of gout compared to men who had maintained their weight. High blood pressure and use of diuretic medication also increased men’s gout risk. This study is the first to show that weight loss in middle age can substantially reduce a man’s risk of gout and that middle-aged men’s risk of developing gout is influenced more by their current weight and body mass than by their weight in early adulthood. The findings support recommendations that obese men with gout should lose weight to prevent recurrent gout attacks.
There’s no cure for gout, but quick, effective treatment can relieve symptoms during an acute attack and can help to prevent future attacks as well as joint damage. The following drugs are used to treat a gout attack.
Non-Steroidal Anti-Inflammatory Drugs
NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Naprosyn) are the preferred treatment for acute gout. Because of their safety and low cost, NSAIDs have replaced colchicine as the treatment of choice. Which NSAID you take is less important than how soon you start taking it. Speed is of the essence to stop an attack from escalating. All oral NSAIDs seem to be equally effective, but some people may respond better to one than another. Significant relief of pain and inflammation usually occurs within 24 hours. Intramuscular injections of ketorolac (Toradol) may also provide relief of acute gout pain. For information on NSAIDs.
Corticosteroids
Oral corticosteroids are effective for acute gout, but because of their side effects, they generally are not used unless you cannot take an NSAID. Pain can also be relieved by injecting corticosteroids directly into an affected joint.
Source: Archives of Internal Medicine, Volume 165, page 742 April 11, 2005
